Meet the Anti-Hippocrates

August 27, 2009

In today’s Wall Street Journal, former NY Lt. Gov. Betsy McCaughey takes a closer look at Dr. Ezekiel Emanuel, Obama’s Health Rationer-in-Chief:

Dr. Ezekiel Emanuel, health adviser to President Barack Obama, is under scrutiny. As a bioethicist, he has written extensively about who should get medical care, who should decide, and whose life is worth saving. Dr. Emanuel is part of a school of thought that redefines a physician’s duty, insisting that it includes working for the greater good of society instead of focusing only on a patient’s needs. Many physicians find that view dangerous, and most Americans are likely to agree.

We’ve been told repeatedly by the President that enacting his healthcare reform plan is necessary to control runaway healthcare costs. Dr. Emanuel admits such claims are mere PR window dressing:

Dr. Emanuel says that health reform will not be pain free, and that the usual recommendations for cutting medical spending (often urged by the president) are mere window dressing. As he wrote in the Feb. 27, 2008, issue of the Journal of the American Medical Association (JAMA): “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely ‘lipstick’ cost control, more for show and public relations than for true change.”

True reform, he argues, must include redefining doctors’ ethical obligations. In the June 18, 2008, issue of JAMA, Dr. Emanuel blames the Hippocratic Oath for the “overuse” of medical care: “Medical school education and post graduate education emphasize thoroughness,” he writes. “This culture is further reinforced by a unique understanding of professional obligations, specifically the Hippocratic Oath’s admonition to ‘use my power to help the sick to the best of my ability and judgment’ as an imperative to do everything for the patient regardless of cost or effect on others.”

There’s the rub. Emanuel apparently views the Hippocratic Oath through the same prism Obama that views the U.S. Constitution, which he disparagingly characterized as “a charter of negative liberties.” Here’s an example of what Emanuel’s vision of an “improved” Hippocratic oath would promote:

In numerous writings, Dr. Emanuel chastises physicians for thinking only about their own patient’s needs. He describes it as an intractable problem: “Patients were to receive whatever services they needed, regardless of its cost. Reasoning based on cost has been strenuously resisted; it violated the Hippocratic Oath, was associated with rationing, and derided as putting a price on life. . . . Indeed, many physicians were willing to lie to get patients what they needed from insurance companies that were trying to hold down costs.” (JAMA, May 16, 2007).

Of course, patients hope their doctors will have that single-minded devotion. But Dr. Emanuel believes doctors should serve two masters, the patient and society, and that medical students should be trained “to provide socially sustainable, cost-effective care.” One sign of progress he sees: “the progression in end-of-life care mentality from ‘do everything’ to more palliative care shows that change in physician norms and practices is possible.” (JAMA, June 18, 2008).

Note the deployment of intentionally imprecise Orwellian language: the alleged progression from a “do everything” mentality to ostensibly more palliative care. In plain English, Emanuel seeks to radically redefine the physician-patient relationship. Instead of serving the best interests of the patient, the progressive physician (or some faceless bureaucrat) will balance the needs of the patient against the needs of the collective. Per Emanuel’s own words, there’s little doubt who will be the winners and losers of this utilitarian calculus:

Dr. Emanuel argues that to make such decisions, the focus cannot be only on the worth of the individual. He proposes adding the communitarian perspective to ensure that medical resources will be allocated in a way that keeps society going: “Substantively, it suggests services that promote the continuation of the polity—those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations—are to be socially guaranteed as basic. Covering services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic, and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia.” (Hastings Center Report, November-December, 1996)

In the Lancet, Jan. 31, 2009, Dr. Emanuel and co-authors presented a “complete lives system” for the allocation of very scarce resources, such as kidneys, vaccines, dialysis machines, intensive care beds, and others. “One maximizing strategy involves saving the most individual lives, and it has motivated policies on allocation of influenza vaccines and responses to bioterrorism. . . . Other things being equal, we should always save five lives rather than one.

It all sounds quite reasonable as long as you disregard actual examples of governments that implemented such progressive ideas.

“However, other things are rarely equal—whether to save one 20-year-old, who might live another 60 years, if saved, or three 70-year-olds, who could only live for another 10 years each—is unclear.” In fact, Dr. Emanuel makes a clear choice: “When implemented, the complete lives system produces a priority curve on which individuals aged roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get changes that are attenuated.”

As Orwell wrote in another context, “All animals are equal, but some are more equal than others.”

The 5th Century B.C. author of the Hippocratic oath wrote: “Whenever a doctor cannot do good, he must be kept from doing harm.” That’s still good advice. Under Emanuel’s version of ObamaCare, will doctors be kept from doing good?


Performance-Enhancing Healthcare

August 20, 2009

The Daily Mail UK reports yet another mind-boggling tale from the wacky world of socialized medicine:

A paedophile with a 30-year history of abusing children is being prescribed Viagra on the NHS – and there is nothing the authorities can do to stop him.

Roger Martin, 71, merely has to visit his GP to obtain the libido-enhancing drug, even though experts warn it will enable him to continue preying on children despite his age.

The probation officers who oversee Martin are powerless to interfere with the administration of prescription drugs.

He does not have to tell his GP about his criminal past and even if he does, doctors cannot take convictions into account.

Martin suffers from numerous illnesses including diabetes, for which Department of Health guidelines say Viagra can be prescribed.

He has forced himself on a string of youngsters and his latest assault was on an 11-year-old girl last year.

NHS criteria may balk at 71-year-olds who need hip replacements, but “performance-enhancing” drugs to help convicted pedophile rapist seniors maintain their “alternative lifestyle” are another story.

Theory vs. Reality

August 10, 2009

Two pictures which perfectly illustrate the difference between theory and reality:











Yankees sweep

Broke ’Bam Putin

August 5, 2009

From the Times UK:

Vladimir Putin has buffed up his action-man image and raised the pin-up stakes among world leaders by posing barechested for another set of holiday pictures.

Photographs were published yesterday showing the Russian Prime Minister stripped to the waist riding a horse through rugged terrain during a brief holiday in the Siberian region of Tuva. Wearing only green fatigues, his eyes hidden behind reflective sunglasses, Mr Putin also showed his gentler side as he fed the horse from his hand after the ride.

Mr Putin, who will be 57 in October, showed off a set of rippling arm muscles as he demonstrated his butterfly swimming stroke. The photos will inevitably trigger mass swooning by women all over Russia — as well as unfavourable comparisons of their husbands to Mr Putin’s manly physique. They will also confirm the Russian Prime Minister’s status as a gay icon.

The latest images are likely intended to remind them that Mr Putin is in robust health exactly a decade after he first came to power as acting Prime Minister in August 1999. The unspoken subtext is that he would be fit to return as president in 2012 if he chose to, ruling for up to another 12 years.

Mr Putin was also following a Soviet tradition of lauding the prowess, usually imaginary, of party leaders such as Leonid Brezhnev, who was fond of hunting for bears and wild boar. He grew so incapable towards the end that KGB officers would drug and tether animals to trees so that Mr Brezhnev could shoot them. President Medvedev, who has previously expressed a love of yoga, has so far refrained from emulating his mentor by stripping off for the cameras (emphasis added).

Amusing stuff. There’s fodder here for enough Big Government propaganda films to keep Hollywood busy for the remainder of Obama’s presidency. Here’s a teaser for one such tribute:

Set against the sweeping vistas of the Siberian region of Tuva to the affluent Hyde Park neighborhood of South Side Chicago, Broke ’Bam Putin is the story of two power-hungry narcissists hell-bent on destroying America. The two unexpectedly forge a lifelong connection, whose complications, joys and tragedies provide a testament to the enduring bankruptcy of Socialism. Based on actual events.